Shoulder MRI: Rethinking Findings

Routine imaging may detect age-related tendon changes that do not explain patient-reported shoulder pain.

By
Kathryn Wighton
February 16, 2026
4 min

MDSpire News

Objective:

To evaluate the prevalence of rotator cuff abnormalities in a population-based cohort of adults aged 41 to 76 years and assess the relationship between these abnormalities and symptoms.

Approach:

Key Findings:

98.7% of participants had at least one rotator cuff abnormality.
25% had tendinopathy, 62% had partial-thickness tears, and 11% had full-thickness tears.
Full-thickness tears were absent in participants younger than 45 years but increased to 28% in those aged 70 and older.
96% of asymptomatic shoulders and 98% of symptomatic shoulders had at least one rotator cuff abnormality.
No meaningful difference in tendinopathy and partial-thickness tears between symptomatic and asymptomatic shoulders.

Interpretation:

MRI-detected rotator cuff abnormalities are common age-related changes and should not be interpreted as reliable indicators of symptomatic disease.

Limitations:

Sample derived from a population-based cohort, limiting conclusions on advanced pathology.
Age range of 41 to 76 years restricts generalizability to younger patients.
Participation required fluency in Finnish or Swedish, limiting applicability to diverse populations.

Conclusion:

MRI findings suggest that rotator cuff abnormalities are prevalent in individuals over 40, regardless of symptoms, indicating a need for cautious interpretation in clinical settings to avoid overtreatment.